Tuesday, April 14, 2015

Fixing The Primary Care Crisis by @Drschimpff

The American health care system is in crisis. Year after year we see prices rise and quality of care spiral downword. The more money we throw at the problem, the worse things get. A bevy of politicians, health care consultants, journalists, and even doctors scurry relentlessly for a solution to to this colossal mess. But, until now, none of them have understood enough to distill the disparate facts into a coherent plan of action.

That all changes with the publication of Dr. Stephen Schimpff's treatise:

Fixing the Primary Care Crisis: Reclaiming the Patient-Doctor Relationship and Returning Healthcare Decisions to You and Your Doctor.

And I'll take this moment to lob my one and only criticism at the book. Dr. Schimpff cogently argues that primary care is the linchpin of high-quality, low-cost care. Thus, in reality, I believe that the title is more aptly "Fixing the Healthcare Crisis". Anyway....

Never have I read such a concise and soup-to-nuts explanation of what has gone so awry in our current system. Our lopsided PCP to specialist ratio, coupled with increasing overhead, and poor reimbursements has turned our doctors into referral machines. The primary care physicians, forced to see in excess of 20 patients a day by an insurance system that under values cognitive medicine, have chosen the path of lease resistance: referrals, diagnostic exams, and procedures. It's not that they don't want to give stellar care, it's just impossible.

Good, high quality medicine, requires time. A luxury that is no longer afforded to those MDs who want to keep their doors open and also collect a paycheck.

The solution is less patients, better reimbursement. Dr Schimpff outlines several ways to achieve this goal including direct practice models, concierge, insurance incentives, and employer based wellness programs. He tackles current trends including ACO's, Patient Centered Medical Homes, and retail pharmacy clinics.

But most importantly, he defines a path forward to correct our mangled version of healthcare.

It all starts with our primary care physicians. Give them less patients and more time to think.

I highly suggest you get the longer, more articulate version of these sentiments and buy Dr. Schimpff's book!